Anyone got experience of Pemphigus foliaceus

[Marquire]

Does anyone have any experience of the autoimmune disease Pemphigus foliaceus?

My poor pony may have it

It started of innocuously enough with a couple of lumps on his side before Christmas whcih came and went and now he has dozens on his tummy and neck and some patches are really big and scabby now with the scabs flaking off to reveal more scabs underneath. he fine in himself, no loss of appetite, the spots/scabs are not itchy and don;t seem to bother him at all.

My vet gave him a course of antibiotics which finished yesterday to see if it was a general bacterial skin infection but there's been no change. The vet is back this afternoon. But the vet said last week when he saw him it looked like this autoimmune thing and if so he'd need skin biopsies to confirm iit, tehn treatment with cortosteroids and gold powder long term with no guarantees that it'd improve it. Plus the side effects of long term steroid use are not good.

I've been researching on the internet (big mistake) and have now scared myself witless as recent research shows that 80% of horses with this disease are euthanised within 12 months of diagnosis.

God it is such a nightmare.

Marie

 

[alsxx]

No experience, but keeping fingers crossed for you both xx

 

[Halfstep]

I knew a foal who had it. It went undiagnosed for a while as vets thought it was a fungal infection/skin problem etc. Eventually it was diagnosed but the foal was very poorly, lost all hair etc. It was treated with various types of steroids (sorry, I don't know all the details). But the foal made a full recovery, is now a strapping great 4 yr old and in work. It seems that if they can get over the problem and get off the steroids ok, the prognosis is quite good. Sorry I don't know any more than this.

 

[fatpiggy]

Steroids. Unfortunately I think that the info you have got from the internet is probably right.

 

[chesterwotsit]

Hi Marie,
Sound like you are in the exact sitiuation that i was in a year ago with one of mine. and yes, you are right it is a nightmare situation with such a rare and vicious condition attacking your horse that no-body really seems to know much about.
Right, the good news is i do still have my horse- the bad news is he is still not well.

over the last 12 months i have consulted vets on this and also spoken to GP's as the condition is more common in humans just to get an idea of the eventual prognosis.

The horse was put onto high doses of the steroid Predenisrone (200x5mg tablets) and you will find that they will make him much more comfortable very quickley. Initally he was also on bute to make him more comfortable until the swollen joints went down.

Im not sure how bad your horses symptoms are - by the time my lad went onto the steroids (about 10 days in from the first skin rash) he had very filled legs and was losing skin and hair from his chest, back, belly and the sorest areas were between his front and back legs which were raw and very crusty where the skin was coming away. his stomuch had also bloated out and he had lost a lot of weight.

once he was on the steroids he was able to move better, go out in the field, graze etc- if you can its best to keep him warm but he may not want rugs on his skin- i use soft blankets and had to just keep putting them back on if they slipped.

if you are having trouble getting the steriods into him with feeding they are fine if you crush them into a paste with a little water and syringe them into his throat like a wormer.

my lad did grow his coat back over the summer but we had to invest in a couple of the snuggy hoods sweet itch outfits to keep the midges from him (a side effect of the steroids is that they make the skin v sensitive) and he had to be stabled on bad midgy days.

if you do get your horse on the road to recovery then you can very gradually lower the dose of the steroids- but be careful as you will find it comes and goes and as soon as you see a rash you must up the dose immeadiatley.

Another harsh lesson i learned was, once he was looking back to his old self again I wormed him- this triggered another bad attack as it promoted an immune responce (to the dead lavee) - he is only just coming good again after that attack.

you have to look long-term with this disease, i am told that the first two years with pemphigus are the worst and then it calms down a little- at the moment its jsut a massive balencing act.

I must say i have only perservered because i keep him with me at home (so costs are lower) and in short he is the best horse i have ever owned and i can't give up on him. we have alos had a homeopathic vet out to him and she beleves that a cure is possible if we get him off the steroids (which at the moment is not possible as he is back up tp 120x 5mg a day- but i have had him down to 40 a day before a relapse in late summer)

if i can be of any further help please say,

Abbie

 

[Janesomerset]

Hi Marie,
I don't have experience of this myself, but I do remember one of the horses at the Mare and Foal Sanctuary in Devon having it. He was called Topper. Sadly, they no longer have Topper, but they nursed him with this condition for quite a time. They are always very helpful if you contact them for advice and would have plenty of good tips if you find your horse has this condition. They have a website where you can ask questions, but I found it more helpful to email their office direct...I did make a donation!

 

[HeatherScotland]

Hi - my year old Dutch Warmblood has recently been diagnosed with Pemphigus Foliaceus. He has been treated with steriods since November which has helped. Biopsies had been inconclusive as it is very difficult to get a clinical diagnosis. New vet has put in a lot of time researching. Condition can be treated with very high doses of steriods which my vet advises as given orally she is not too worried by side effects. Steriods can be treated with another drug - sorry can't remember name but would need careful monitoring but with this treatment horse would be less likely to require maintenance. We are going down the Homeopathic route as this seems to have the greatest success. My vet was put in touch with Tim Couzens in Sussex who is the homeopathic consultant for Hilton Herbs & he has given us the name of a homeopathic vet in Glasgow who I am going to contact today. I have found that keeping the coat very short & washing instead of brushing helps. I have been using a wash, cream & spray from Botanica Ireland which helps keep the grease & scaling down. I scared myself by researching on the internet also however I am now feeling much more positive. Good luck.

 

[Marquire]

Just to update you.

The vet came back on Tuesday and took four skin biopsies from four different sites on his tummy (not nice to watch I can tell you!). So he now also has stitches so of course I immediately started worrying whether they would heal okay or not.

The vet sent the biopsies away to Newmarket for analysis and we should have the results next week. Although he has warned me that it is difficult to diagnose with any certainty (as some of you have already said).

I was pretty down about it on Wednesday- thinking the worst but last night when I went to see him, I felt much better. The biopsy sites are healing nicely and after a thorough examination, I am confident to say he doesn't have any new bumps and some of the older ones which were scabbed have lost their scabs and the skin underneath looks pink and healthy. He still has three patches which are scaly and horrible but the smaller scabby bits now look more like normal scabs (if that makes sense).

As the weather is now almost tropical up here (15oC yesterday!) I'm planning to give him a hibiscub bath on Saturday. If it is PF this will do no good I know but at the very least it'll be a nice experience for him after having rugs on all winter. Luckily my yard has a hot shower for the horses and he loves it!

Marie

 

[Blitzy Boy]

Just a bit of hard earned info for anyone with horses suffering from a pemphigus whether it be foliaceus or vulgaris, hoof, coronary band or skin, BRIGHT SUNLIGHT MAKES IT WORSE so get a nice big loose fly coat and a strong full face and ear fly mask for turning out in the summer months or keep inside on the hottest days and turn out after the suns gone down. I cover my boys coronary band with old pairs of thick denier black tights cut to size and tied on under his fetlocks, keeps the sun and flies off without him really noticing he’s wearing them. All my girlfriends now keep their old winter tights ready for me to use during the summer (he wears the snazzy patterned or diamonte enhanced ones for best!) We’ve been battling this disease for coming up to 7years now which is more than half my lovely boys life and have had to accept there is no cure yet luckily it mostly only effects his feet and he doesn’t seem to get depressed lose his appetite or even go lame, in the hottest of summers he can lose the hair from his ears, around his eyes, cheeks and under his chin but this year I found rubbing Johnson’s baby sensitive skin massage oil in those areas daily stopped it from getting too bad and the hair grew back even before the end of the summer. Having read a lot about far worse cases I feel we got off easily. Keeping his feet super clean particularly in the summer when everything gets worse is hard work and a daily if not twice daily chore which will probably have to be done for the rest of his life but he’s learned to be a gentlman about it after all this time and now holds his feet up ready without being asked as I move around them in the same order everyday. The first 2years were worse for both of us, for him, learning to be patient about a variety of useless treatments I inflicted on him and for me getting the correct diagnosis and then accepting it wasn’t curable or even my fault that he has it was the biggest step. Now we’re both older and more stoic about it so we enjoy what we have, riding more in the winter using steroids for a few months only if it looks like the hoof, frog coronary band etc is growing in a deformed way and needs a bit of help to boost correct regrowth. If anybody out there needs to pick my brains or just generally have a shoulder to moan on, feel free.
Sandy

 

[Gloi]

remembered this thread from a while ago
https://forums.horseandhound.co.uk/threads/auto-immune-diseases-pemphigus.465431/